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APPLICATION FOR RIGHT-OF-WAY USE PERMIT <br />ki <br />Type or print clearly with ink <br />PRESS HARD - YOU ARE MAKING COPIES <br />PUBLIC WORKS <br />EVERETT. WASHINGTON IT <br />APPLICANT (UNDERSIGNED) AND FIRM REPRESENTED, IF ANY: <br />HEREBY APPLIES FOR PERMISSION TO12 <br />AT THE FOLLOWING LOCATION <br />DRAWING (WORK TO BE DONE) OR THREE PLANS ATTACHED: <br />PERMIT IS VALID FOR 60 DAYS <br />COPY OF THIS APPLICATION TO BE POSTED <br />ON JOBSITE. <br />CALL FOR INSPECTION 259-881 1 <br />24 HOURS BEFORE CONSTRUCTION <br />SEWER <br />DRAINAGE <br />li WATER <br />DEPARTMENT APPROVALS <br />COMMUNICATIONS <br />TRAFFIC <br />PLANNING <br />STREET yJ/ X� f17 <br />APPROVED FOR CONSTRUC ION GATE <br />�_ 29 AWAY 80 <br />AW'YED ASONSIRUCTED DATE <br />DRIVEWAY SECTION <br />+I" LIP <br />1 30" <br />The undersigned owner hereby agrees to hold and save harmless <br />the City of Everett from any and all claims for damages. costs. <br />expenses, or causes of action that may arise because of installation <br />and maintenance of the improvement or other nght-of-way use <br />hereto applied for and further agrees to remove same upon notice <br />from the City and to replace public property damaged thereby, <br />� 2 5235 _ <br />TELE(I4ONE NUMBER ALTERNATE <br />--w /9� <br />CONSTRUCTION/AS BUILT <br />Ix ..V'". <br />1978 <br />